阻塞性睡眠呼吸暂停的精准医学
Precision Medicine for Obstructive Sleep Apnea.
作者信息
Light Matthew, Owens Robert L, Schmickl Christopher N, Malhotra Atul
机构信息
Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, 9300 Campus Point Drive #7381, La Jolla, CA 92037-7381, USA.
Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, 9300 Campus Point Drive #7381, La Jolla, CA 92037-7381, USA.
出版信息
Sleep Med Clin. 2019 Sep;14(3):391-398. doi: 10.1016/j.jsmc.2019.05.005. Epub 2019 Jul 4.
Abstract
Increasingly, obstructive sleep apnea treatment is being recognized as amenable to a precision medicine approach. Many pathophysiologic mechanisms (endotypes) beyond anatomic compromise have now been identified and are readily determined during polysomnography, although randomized controlled trials of endotype-specific therapies are needed. Research indicates that endotypes may also be important in predicting both adherence to therapy and disease consequences (phenotypes). Biomarker discovery and Big Data approaches derived from wearable technology are areas of active investigation and may allow more robust conclusions to be drawn over time, such that patients may soon fully realize the benefits from fresh insights into sleep science.
摘要
越来越多的人认识到，阻塞性睡眠呼吸暂停的治疗适合采用精准医学方法。目前已经确定了许多超出解剖结构受损范围的病理生理机制（内型），并且在多导睡眠图检查过程中很容易确定，不过仍需要针对内型特异性疗法进行随机对照试验。研究表明，内型在预测治疗依从性和疾病后果（表型）方面可能也很重要。可穿戴技术衍生出的生物标志物发现和大数据方法是正在积极研究的领域，随着时间的推移可能会得出更有力的结论，从而使患者可能很快就能充分从睡眠科学的新见解中受益。
相似文献
1
Precision Medicine for Obstructive Sleep Apnea.阻塞性睡眠呼吸暂停的精准医学
Sleep Med Clin. 2019 Sep;14(3):391-398. doi: 10.1016/j.jsmc.2019.05.005. Epub 2019 Jul 4.
2
A Novel Model to Estimate Key Obstructive Sleep Apnea Endotypes from Standard Polysomnography and Clinical Data and Their Contribution to Obstructive Sleep Apnea Severity.一种基于标准多导睡眠图和临床数据估计关键阻塞性睡眠呼吸暂停表型的新模型及其对阻塞性睡眠呼吸暂停严重程度的贡献。
Ann Am Thorac Soc. 2021 Apr;18(4):656-667. doi: 10.1513/AnnalsATS.202001-064OC.
3
[Techniques for quantifying endotypes of obstructive sleep apnea].[阻塞性睡眠呼吸暂停内型量化技术]
Zhonghua Jie He He Hu Xi Za Zhi. 2024 Apr 12;47(4):383-388. doi: 10.3760/cma.j.cn112147-20231027-00274.
4
Phenotyping the pathophysiology of obstructive sleep apnea using polygraphy/polysomnography: a review of the literature.使用多导睡眠图/多睡眠图对阻塞性睡眠呼吸暂停的病理生理学进行表型分析：文献综述。
Sleep Breath. 2018 Sep;22(3):579-592. doi: 10.1007/s11325-017-1613-3. Epub 2018 Jan 9.
5
The Combination of Supplemental Oxygen and a Hypnotic Markedly Improves Obstructive Sleep Apnea in Patients with a Mild to Moderate Upper Airway Collapsibility.补充氧气与催眠药物联合使用可显著改善轻至中度上气道可塌陷性患者的阻塞性睡眠呼吸暂停。
Sleep. 2016 Nov 1;39(11):1973-1983. doi: 10.5665/sleep.6226.
6
A randomized controlled trial of oxygen therapy for patients who do not respond to upper airway surgery for obstructive sleep apnea.一项针对对上气道手术治疗阻塞性睡眠呼吸暂停无反应患者进行氧疗的随机对照试验。
J Clin Sleep Med. 2021 Mar 1;17(3):445-452. doi: 10.5664/jcsm.8920.
7
Continuous positive airway pressure improves sleep and daytime sleepiness in patients with Parkinson disease and sleep apnea.持续气道正压通气可改善帕金森病合并睡眠呼吸暂停患者的睡眠和日间嗜睡。
Sleep. 2014 Jan 1;37(1):177-85. doi: 10.5665/sleep.3332.
8
Application of Personalized, Predictive, Preventative, and Participatory (P4) Medicine to Obstructive Sleep Apnea. A Roadmap for Improving Care?个性化、预测性、预防性和参与性（P4）医学在阻塞性睡眠呼吸暂停中的应用。改善护理的路线图？
Ann Am Thorac Soc. 2016 Sep;13(9):1456-67. doi: 10.1513/AnnalsATS.201604-235PS.
9
Tailored treatment strategies for obstructive sleep apnea.阻塞性睡眠呼吸暂停的个性化治疗策略
Respir Investig. 2016 Jan;54(1):2-7. doi: 10.1016/j.resinv.2015.09.007. Epub 2015 Dec 8.
10
Further Development of P4 Approach to Obstructive Sleep Apnea.阻塞性睡眠呼吸暂停P4治疗方法的进一步发展
Sleep Med Clin. 2019 Sep;14(3):379-389. doi: 10.1016/j.jsmc.2019.05.004. Epub 2019 Jul 4.
引用本文的文献
1
[Respiratory Disease in the Era of Big Data].[大数据时代的呼吸系统疾病]
Open Respir Arch. 2020 Oct-Dec;2(4):284-288. doi: 10.1016/j.opresp.2020.07.003. Epub 2020 Sep 10.
2
The role of upper airway and facial skeleton anatomy in the evolution of obstructive sleep apnea: an 8-year follow-up.上气道和面部骨骼解剖结构在阻塞性睡眠呼吸暂停中的作用：一项 8 年随访研究。
Sleep Breath. 2024 Mar;28(1):401-409. doi: 10.1007/s11325-023-02907-z. Epub 2023 Sep 8.
3
Role of precision medicine in obstructive sleep apnoea.精准医学在阻塞性睡眠呼吸暂停中的作用。
BMJ Med. 2023 Jan 5;2(1):e000218. doi: 10.1136/bmjmed-2022-000218. eCollection 2023.
4
Computed Tomography and Cephalometric Evaluation of Obstructive Sleep Apnea Syndrome.阻塞性睡眠呼吸暂停综合征的计算机断层扫描和头影测量评估
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5134-5143. doi: 10.1007/s12070-021-02980-4. Epub 2021 Nov 24.
5
Planetary sleep medicine: Studying sleep at the individual, population, and planetary level.行星睡眠医学：在个体、人群和行星层面研究睡眠。
Front Public Health. 2022 Oct 18;10:1005100. doi: 10.3389/fpubh.2022.1005100. eCollection 2022.
6
Patient preferences in obstructive sleep apnea-a discrete choice experiment.患者在阻塞性睡眠呼吸暂停中的偏好——离散选择实验。
Sleep Breath. 2022 Dec;26(4):1717-1727. doi: 10.1007/s11325-021-02549-z. Epub 2022 Jan 10.
7
Epigenetics of Sleep Disorders: An Emerging Field in Diagnosis and Therapeutics.睡眠障碍的表观遗传学：诊断与治疗中的一个新兴领域
Diagnostics (Basel). 2021 May 10;11(5):851. doi: 10.3390/diagnostics11050851.
8
Breathing Re-Education and Phenotypes of Sleep Apnea: A Review.呼吸再教育与睡眠呼吸暂停的表型：综述
J Clin Med. 2021 Jan 26;10(3):471. doi: 10.3390/jcm10030471.
9
Redox-Oligomeric State of Peroxiredoxin-2 and Glyceraldehyde-3-Phosphate Dehydrogenase in Obstructive Sleep Apnea Red Blood Cells under Positive Airway Pressure Therapy.气道正压通气治疗下阻塞性睡眠呼吸暂停患者红细胞中过氧化物酶2和甘油醛-3-磷酸脱氢酶的氧化还原寡聚状态
Antioxidants (Basel). 2020 Nov 26;9(12):1184. doi: 10.3390/antiox9121184.
10
The effects of mandibular advancement appliance therapy on jaw-closing muscle activity during sleep in patients with obstructive sleep apnea: a 3-6 months follow-up.下颌前移矫治器治疗对阻塞性睡眠呼吸暂停患者睡眠期间咬肌活动的影响：3 - 6个月随访
J Clin Sleep Med. 2020 Sep 15;16(9):1545-1553. doi: 10.5664/jcsm.8612.
本文引用的文献
1
Metabolomic and lipidomic profile in men with obstructive sleep apnoea: implications for diagnosis and biomarkers of cardiovascular risk.男性阻塞性睡眠呼吸暂停的代谢组学和脂质组学特征：对诊断和心血管风险生物标志物的影响。
Sci Rep. 2018 Jul 26;8(1):11270. doi: 10.1038/s41598-018-29727-6.
2
Exosomal Cargo Properties, Endothelial Function and Treatment of Obesity Hypoventilation Syndrome: A Proof of Concept Study.外泌体货物特性、血管内皮功能与肥胖低通气综合征治疗：概念验证研究。
J Clin Sleep Med. 2018 May 15;14(5):797-807. doi: 10.5664/jcsm.7110.
3
Palatal prolapse as a signature of expiratory flow limitation and inspiratory palatal collapse in patients with obstructive sleep apnoea.腭下垂作为阻塞性睡眠呼吸暂停患者呼气流量受限和吸气性腭下垂塌陷的特征。
Eur Respir J. 2018 Feb 14;51(2). doi: 10.1183/13993003.01419-2017. Print 2018 Feb.
4
Phenotyping Pharyngeal Pathophysiology using Polysomnography in Patients with Obstructive Sleep Apnea.使用多导睡眠图对阻塞性睡眠呼吸暂停患者的咽病理生理学进行表型分析。
Am J Respir Crit Care Med. 2018 May 1;197(9):1187-1197. doi: 10.1164/rccm.201707-1435OC.
5
Recognizable clinical subtypes of obstructive sleep apnea across international sleep centers: a cluster analysis.在国际睡眠中心中可识别的阻塞性睡眠呼吸暂停临床亚型：聚类分析。
Sleep. 2018 Mar 1;41(3). doi: 10.1093/sleep/zsx214.
6
Changing Faces of Obstructive Sleep Apnea: Treatment Effects by Cluster Designation in the Icelandic Sleep Apnea Cohort.阻塞性睡眠呼吸暂停的变化面貌：冰岛睡眠呼吸暂停队列中按聚类设计指定的治疗效果。
Sleep. 2018 Mar 1;41(3). doi: 10.1093/sleep/zsx201.
7
Adherence to Positive Airway Therapy After Switching From CPAP to ASV: A Big Data Analysis.从 CPAP 切换到 ASV 后对正压通气治疗的依从性：大数据分析。
J Clin Sleep Med. 2018 Jan 15;14(1):57-63. doi: 10.5664/jcsm.6880.
8
Measuring Loop Gain via Home Sleep Testing in Patients with Obstructive Sleep Apnea.通过家庭睡眠测试测量阻塞性睡眠呼吸暂停患者的环路增益
Am J Respir Crit Care Med. 2018 May 15;197(10):1353-1355. doi: 10.1164/rccm.201707-1357LE.
9
Patient Engagement Using New Technology to Improve Adherence to Positive Airway Pressure Therapy: A Retrospective Analysis.利用新技术提高患者对气道正压疗法的依从性：一项回顾性分析。
Chest. 2018 Apr;153(4):843-850. doi: 10.1016/j.chest.2017.11.005. Epub 2017 Nov 15.
10
Update in respiratory sleep disorders: Epilogue to a modern review series.睡眠呼吸障碍的最新进展：现代综述系列结语
Respirology. 2018 Jan;23(1):16-17. doi: 10.1111/resp.13211. Epub 2017 Nov 6.
Zotero 插件